Amylase in Infancy: Can Babies Digest Starch?

by Alice Callahan on November 8, 2013

Several readers have emailed me to ask about babies’ ability to digest starch. Here’s one:

“I have noticed you recommending cereals for babies several times. I am sure that you are aware that many people look at feeding a baby grains before the age of one or even two as if you have offered your child strychnine. One of the reasons cited is that they supposedly do not have amylase to digest grains before that time. I have often wondered what exactly is happening to the cereal if it is not being digested, but the only statement I could find is something about it “rotting” in the gut.

I would love to get information from a scientific point of view on this topic. Everything I have been able to find thus far has been very biased towards one point of view or another. Either “cereal is the perfect first food. Easy to digest and enriched with iron” from the infant cereal companies or “Cereal is junk. No infant should ever eat grains. It is not natural or traditional and they can’t digest it” from online parenting sites.

I need a little clarity and common sense.”

~Hope

I love the skepticism in Hope’s email, and I can also empathize with her frustration about how difficult it is to find good information about a seemingly simple question: Can babies digest starch? If you search for the answer to this question online, you will run into dire warnings of the dangers of giving starch to babies. But these sites might set off your woo detector – as they should. So, after receiving multiple emails about this question as well as seeing it mentioned in discussions on the Science of Mom Facebook page, I figured it was time to put some evidence-based information about babies and starch digestion on the Internet.

Researching this question has given me an excuse to read some classic nutrition physiology papers harkening back to the 1960’s and 1970’s, and it’s brought back memories of years in the lab, exploring nutrient digestion and metabolism. And starch digestion in infancy, it turns out, is a really neat story.

Let’s start with some basics about carbohydrate digestion.

What is starch? How is it digested?

Starch is a type of complex carbohydrate. Made from lots of glucose molecules bonded together in long, branching chains, it is a plant’s way of storing glucose – product of photosynthesis and source of energy – in a stable form. We find starch in grains, root vegetables, winter squashes, beans, and some fruits, like bananas. Starch is an important storage depot for the plant, and it also makes for tasty staple foods for cultures around the world.

A chain of 3 glucose molecules, like a tiny section of starch.

Glucose is the major fuel for the cells of the body. When we eat starch, we have to break the bonds in those chains of glucose molecules, liberating them to be absorbed from the small intestine into our blood. Starch digestion begins in the mouth, where salivary amylase starts chopping up those large glucose chains. When this partially digested starch gets to the small intestine, amylase made and secreted by the pancreas jumps in to do more bond-breaking and is responsible for most of starch digestion in adults. A suite of enzymes produced by the cells lining the small intestine, including sucrase, isomaltase, maltase, and glucoamylase, work on the remaining short chains, finishing up the job and making glucose available for absorption.

Starch Digestion in Infants

Infants go through some incredible nutritional transitions in the first months of life. Prior to birth, their growth and development is fueled almost entirely by glucose from mom, absorbed across the placenta. After birth, they have to abruptly transition to an exclusive milk diet, which is high in fat and lactose, still a relatively simple sugar. As they start solid foods, babies have to adapt to a much more complex and varied diet. Around the world, starch is a major source of energy in the diets of children and adults alike. But when infants are first introduced to starchy foods – often in the form of cereals and porridges – starch is a novel nutrient to their digestive tract. They need to turn it into glucose, but are they equipped to do this?

It’s true that infants have low levels of pancreatic amylase, the workhorse of starch digestion in adults. Research in the 1960’s and 1970’s showed that pancreatic amylase activity, measured in samples of fluid from the small intestine, is almost non-existent in newborns.1,2 Activity starts to increase within the first six months, however, and continues ramping up throughout childhood.1 By four to six months, when many babies are introduced to starch in the form of cereals, there is some pancreatic amylase activity, but still much less than that found in older children and adults.

Looking at these results, scientists questioned whether babies could handle starch very well. But they didn’t throw up their hands and declare, “No starch for babies!” They kept asking questions and seeking answers. They must have been puzzled by the fact that babies appeared to digest starch just fine. For example, think of the experience of those who are deficient in another carbohydrate-digesting enzyme, lactase, which allows us to digest lactose, the carbohydrate in milk. What happens if they drink a glass of milk? They have obvious, uncomfortable symptoms of diarrhea, nausea, cramping, bloating, and gas. These symptoms weren’t apparent in young babies eating infant cereals, which in the U.S. in the 1970’s, were usually introduced to babies by 1-2 months of age.3 My mother-in-law recorded my husband’s first teaspoon of doctor-recommended rice cereal in his baby book at 4 weeks, yet her careful records didn’t include any concerns about a sudden onset of diarrhea.

Baby book, ca. 1975

And this approach to infant feeding wasn’t that unique to the U.S. Ethnographic reports are filled with examples of starchy first foods4 for young infants around the world: Millet flour at 3 months in Tanzania; corn porridge at 3 months in Zimbabwe; beans and rice at 4 months in Brazil; a little butter and flour at 3 days in Bhutan; rice mash at 3 weeks in Nepal; and prechewed taro root at 2 weeks in the Solomon Islands. If babies were eating starch this young, with no apparent clinical signs of malabsorption, there must be more to the story.

The studies of pancreatic amylase activity had only measured its activity in a test tube in the lab. Next, researchers took a more holistic approach and measured starch digestion in the babies themselves. A 1975 Italian study5 added starch from different sources (potato, tapioca, corn, wheat, and rice) to 1-3-month-old babies’ formulas and then checked to see what came out at the other end –- in the babies’ poop. It turned out that very little starch ended up in these babies’ diapers. When they were given between 1 tablespoon and ½ of a cup of starch per day, they appeared to digest more than 99% of it. The researchers then tried a larger dose, giving several 1-month-olds a full cup of rice starch. Three of these infants absorbed more than 99% of this amount. Two absorbed just 96%, the other 4% ending up in their diapers, along with some diarrhea. In other words, within the first few months of life, babies can digest small amounts of starch just fine, but give them too much and you’ll see some diarrhea. (And no, I’m not suggesting that we feed 1-month-olds cereal – this was just the research at the time.)

How is this digestion of starch possible if babies have so little pancreatic amylase at work?

2. Human breast milk has lots of amylase, 25x that found in raw cow’s milk.10 Interestingly, it is highest in colostrum,11 and decreases slowly during infancy, as salivary and pancreatic amylases are increasing. Like salivary amylase, breast milk amylase retains at least 50% of its activity12 even after several hours of exposure to the low pH of an infant’s stomach, passing into the small intestine ready to get to work.13 It also seems to be protected by proteins in breast milk. One researcher estimated that the amylase in 100 ml of breast milk was capable of digesting 20 grams of starch (equivalent to 2/3 cup of dry rice cereal) in one hour.14 This is one good reason to use breast milk to make up cereals for young babies, and studies show that amylase is stable in breast milk for hours even after repeated freezing and thawing.11

3. Glucoamylase helps out in the small intestine. Glucoamylase is an enzyme made by the cells lining the walls of the small intestine. Like amylase, it breaks the bonds between glucose molecules in starch and shorter glucose chains. But unlike pancreatic amylase, glucoamylase is very active in infants, reaching adult levels as early as 1 month of age.15,16

All of these sources of starch-digesting enzymes – salivary and breast milk amylase, as well as glucoamylase in the small intestine – appear to work together to help babies digest starch to glucose. But that isn’t the end of the story.

Studies have shown that a significant fraction of dietary starch isn’t digested in the small intestine of babies but passes on to the large intestine.17,18 Is this where it “rots” in the gut, as the alarmist blog posts claim? Not so fast. Bacteria in the colon ferment (quite a different process from rotting) these undigested carbohydrates as part of the healthy symbiotic relationship between our gut microbes and us humans. It happens in adults, too. Even with their full activity of pancreatic amylase, some starch escapes digestion in the small intestine, as does dietary fiber.19

These undigested foods help feed the microbes, who kindly benefit usin lots of ways. The end products of microbial fermentation in the colon are short chain fatty acids, which can improve nutrient absorption, enhance gut health, and even be used as a source of energy for both the microbes and the human host.20 Babies and toddlers may actually have faster colonic fermentation of starch than adults, which might represent an important pathway for them to fully capture the nutrients in their food.21 The addition of complex carbohydrates, including starch and fiber, to the diet of older babies and toddlers might help to develop those healthy microbes.22

OK, so maybe babies can handle starch just fine. But is there any harm in waiting a year or two to introduce it, just in case?

I can think of a few reasons why we should be careful about limiting starch in a baby’s diet:

1. Waiting too long to introduce grains to your baby could end up increasing the risk of developing celiac disease, Type 1 diabetes, and wheat allergy.23–25There seems to be a sweet spot kind of window in mid-infancy – probably between about 5 and 7 months, where introduction to a variety of foods, including grains, decreases baby’s risk of developing chronic disease and allergies later in life.

2. Eliminating starch can make it more difficult for babies to get the nutrients they need. Infant cereals are fortified with iron, one of the nutrients most likely to be limiting to infants, even in the developed world. They are stable for long-term storage, and it’s convenient to mix up just a tablespoon of cereal at a time. You can certainly meet the nutrient needs of babies without cereals, but it takes more work and experimentation. When Cee was a baby, she was not at all interested in eating fortified baby cereals, and I found other sources of iron for her. But if your baby likes cereals, I wouldn’t hesitate to include them as one of a variety of foods in his diet. Also, this concern about starch digestion and amylase tends to be focused on avoiding grains, but remember that legumes and many fruits and vegetables also have lots of starch. If you truly tried to avoid starch, you would really be limiting your baby’s opportunities to gain nutrients and experience with different tastes and textures.

3. There may be negative consequences to being anxious and restrictive about food with young children. We seem to have an ongoing obsession with restrictive diets. It used to be all about restricting fat, then all carbohydrates, and now grains are getting a bad rap. I don’t think this is healthy. Barring allergies or intolerances, eating a variety of foods from all the food groups pretty much ensures that you’ll meet your nutrient requirements without even trying. It allows you to relax and enjoy your food with the people you love, which is really what eating should be about. When you start eliminating food groups, you increase your risk of nutrient deficiencies, increase anxiety about food, and make it more difficult to share food. It’s one thing to make this choice as adults, but in my opinion, to impose it unnecessarily on our kids isn’t fair. When a two-year-old isn’t allowed to have a cupcake at a birthday party, he might feel different and deprived, and he’s lost a chance to practice eating treats in moderation. Parents of kids with food allergies have to work carefully to manage these situations, but for the rest of us, this kind of restriction is unnecessary.

The bottom line is that it is safe to feed babies starchy foods. They can digest them, and they are one part of a varied, balanced diet for babies that are ready to begin eating solid foods. I’ll be writing more about the transition to solid foods in the next few weeks.

What I love about this blog is that it introduces me to things I hadn’t even considered, and clarifies points that are bouncing around in my head otherwise. Thank you for yet another well thought out, carefully considered essay. Keep up the great work!
p.s. Both my kids had iron-fortified oatmeal mixed with breastmilk around 6 months, and loved it.

I’m glad it clarified some things for you! I debated about whether to write about this on the blog, because I really think it isn’t on the radar for most parents. I asked a pediatrician friend if she has been asked about amylase activity in infants, and she had no idea this was a concern of parents. But all it takes is a mention from a friend, probably online, to inspire us to wonder about it (and maybe be anxious and wonder if we’re doing the right thing). And boy, if you do a Google search for this topic, you find some misinformation. I wanted to have a detailed and accurate post about this online, but interestingly, I’m condensing it down to just a paragraph or two for my book (because again, it isn’t on the radar of most parents). Anyway, thanks for the encouragement! Glad you find it useful!

You’re right, it is a hot topic among certain circles. I hope this post finds its way into those circles! I’m not entirely sure what to recommend for types of grains yet – I’m doing more research on that now. The benefit of more processed grains are that they are more digestible. The transition to solid foods is a big change for babies’ digestive tracts, and I’m not sure we want to *start* with whole grains that are going to add to the challenge. I have been interested to learn in my research that mamas prechewing foods for babies is a common theme in ethnographic reports (contributing their own amylase). That is, in a way, the first form of processed foods for babies. I definitely recommend introducing a variety of cereals. I think the findings of arsenic in rice cereal emphasize the importance of variety – maybe include rice a couple of times per week, but rotate with oatmeal, wheat, barley, etc. And I think that you can quickly progress to more whole grains. But again, I’ll research this question more and post on it soon.

Again, Thanks! I never understood the hullabaloo Alicia Silverstone got over her premastication practices, we see it alllllll over the animal kingdom, why wouldn’t humans do it too? Not saying I’d feel a need to share it on the internets (or even that it’s something I’d feel compelled to do regularly) but it doesn’t seem THAT weird.

Did you ever follow this up? I have a 4 month old that I am exclusively breastfeeding at the moment and currently researching the topic of food introduction and weaning. I am hoping to hold out until 6 months before introducing solids and also swaying towards a baby led style of weaning with traditional foods like egg yolk, bone broth, avocado as babies first foods. I had read somewhere about not introducing grains until 12 months although after reading this article it has helped to clarify this. I am not interested in giving my child infant cereal however wondering which grains are suitable first foods? I am confused as to whether some may be too high in fibre. Are things like quinoa, millet or amaranth suitable and how about seeds like chia? And how about the dairy debate? What is the science behind cows milk and cheese?

I’ve always been baffled by the level to which the fear of “processed” foods for babies has gone. The only food that a 6 month old infant could eat without some form of processing is breast milk. Everything else needs to be ground, chopped, mashed, boiled, pureed in order to make it both safe and edible. But the word “processed” seems to have taken on a life of its own, where people forgetting that if you don’t process foods for babies, you’ll generally see them come out the other end in the same form they went in at the top end!

Well I’m super glad that you did this post. I was thought I needed to wait till at least the first birthday to start introducing starches. My 8.5 month old has been missing out! She has had some poi, but I was blaming contipation on her not being able to digest the poi (a hawaiian puree’d root). I just gave my daughter cereal after reading this and she loved it!

Thank you! This is a great example of why I am a subscriber and why what you write is so worthwhile! Keep up the great work. Very interesting, and very encouraging to expose our little mouths to all the bounty of food we have at our fingertips these days, without worry.

Yay, thanks! I’m glad you find it interesting. Funnily enough, digestion put me to sleep in grad school, but somehow digging through all these papers was like trying to solve a suspenseful mystery for me:) And I agree, variety is key to enjoying and exploring food for all us.

Thanks so much for this post! I first heard about lack of amylase right around the time I started solids with Gus, but took the entirely not scientific route of “I’ve never heard that before so it’s probably not true / not a big deal”. But it was a little niggle in the back of my mind, so it is very reassuring to read the science behind it. And know I don’t have to worry for next time!

I actually think your response is a very good approach. If you don’t have time to research a question yourself (which in this case required reading several dozen papers going back decades), you’ve never heard the concern before, and you can’t find a reputable source of information on it, it’s probably safe to ignore it:) I’m always happy to be able to help parents relax a little about feeding!

I know this is an older post, but these ^^^^ are my thoughts exactly! I ran into this whole “don’t feed baby any grains” idea a few years ago and I feel like it’s been popping up here and there every since. I knew it sounded wrong, but I didn’t have any reasons or scientific evidence for why. Thanks for doing the research! And I completely agree … never heard it before? Seems extreme? No reputable sources for the info? Be very cautious about buying into that idea, no matter how many scary “facts” are being presented!! There are a lot of very questionable trends floating around on the internet! 😀

Wow! I am so grateful for the research you put into this post and how much information you provide for the reader!!! Not only do you cover the scientific support for the ability of starch digestion in infants but you also discuss the psychology behind not restriciting/limiting the introduction of food. This is a fantastic post!!! Since I was unable to breastfeed it was helpful to learn that there were other sources of amylase. Thank you!

I stumbled on this blog whilst trying to sort the wheat from the chaff on the internet about baby care (so to speak, in the context of this particular post)! All I ever seemed to find was people arguing and exchanging anecdotes, and if I was lucky there would be advice from doctors. But the advice and arguments never pointed to any real literature and it seemed to me that a lot of the things about which they were arguing were so basic and obvious that there had to be some good science behind them! You can imagine my pleasure when I found someone willing and able to do the hard yards and actually research these issues – and then put it all together for us in a way that is digestible but well-cited…my goodness I am on a roll today aren’t I? I am a mother of two, and also a scientist. My career focus has been on studying the evolution of modern people, from the perspective of the fossil and archaeological records. In addition to the obvious joys and trials I share with my children, they have given me terrific insight into the incredible development we human beings go through to become the complex adults we are. In a bizarre way, the experience with my children has highlighted what I already knew about the beauty and precision of our evolution. Thank you so much for offering something online that is accessible, sensible, and well-written! Jess

Thanks – what a lovely comment! Does the finding of high levels of amylase in human milk intrigue you, from an evolutionary perspective? I think it is sort of funny in light of the many times I’ve seen a statement online like, “Babies are designed to drink breast milk; they aren’t designed to eat grains.” I object to the idea that either breast milk or babies were designed at all, but if you’re going down that road, you might wonder why amylase has such high activity in human milk. It’s quite possible that it’s a fluke and has never been much of an advantageous thing to have in the feeding of infants – but maybe it has. I haven’t yet dug around more for other species comparisons. The finding that cows milk doesn’t have much amylase isn’t too surprising given that they’re ruminants.

I’m glad you appreciated the comment, even with all the terrible food-related puns! I do think that is intriguing that human breast milk has a lot of amylase. There are so many instances of this sort of beautiful balance in evolution, and sometimes problems are solved in unexpected ways. As you say, it often leads to the impression that there must be some sort of purposeful design behind such elegance, when to me it is the absence of such design that adds to how amazing these adaptations are. Of course, we have tampered with our own evolution many times before and future populations of humans will undoubtedly continue to do so. For example, I would not be surprised if the high amount of amylase in breast milk is a relatively recent adaptation related to cultural practices that began in the late Pleistocene (e.g. ca. 12,000 years ago). The advent of more intensive use of starchy grains/plants, or even agriculture was mediated by new technologies and recursive changes in population dynamics. So for example, grinding stones are not very popular amongst mobile hunter-gatherers, which we have been for most of our lives, because they are heavy and cumbersome. But they do allow for more intensive processing of grains and starchy roots, amongst other things. Similarly, new technologies and ways of using the land are essential for moving from hunting and gathering to a more sedentary lifestyle, which goes hand in hand with agriculture and changes in the size of a population that can be supported by a given area of land. This then leads to more people, larger populations, and all of the other things that come along with that that have the potential to change our biology (e.g. diseases, commensal relationships with animals and plants), and so forth. To me this could be a story much like how the ability of (some) humans to digest lactose beyond infancy is quite a recent evolutionary phenomenon and really only is prevalent in populations with a long history of incorporation of dairy products into their diets. Quite simply, we have adapted our biologies to suit our cultural practices in this and other examples, and this has happened very quickly in evolutionary terms. Amylase in breast milk could be a similar phenomenon.

Thanks for another great post. Yet again I’ll be pointing parents in the direction of your blog when this topic comes up. And you can assure your paediatrician friend that it comes up often at Child Health Clinic. I’ve found many mothers have become anxious about introducing cereals for fear of causing allergies. As with most topics I think a little bit of common sense goes a long way and a balanced diet seems less likely to cause problems than a restrictive (and therefore unbalanced) one.

You’re welcome! Thanks for sharing my blog with other parents. I’m sure that my pediatrician friend gets lots of questions about grains and celiac and allergies, but she hadn’t heard this particular concern about amylase (yet).

Wow–I had read books/articles discouraging “spiking” breastmilk or formula with cereal in the early months, but had no idea that some sources suggest holding off grains for a year or two(!). Our son’s first starchy food was sweet potato at around 5 months; we followed up soon after with his first grain, spelt baby cereal, which he loved.

I really appreciate your point about downplaying food anxiety. We’ve never done an allergy test, but it seems our son is intolerant to eggs served plain (he’s fine eating baked goods made with eggs). Food intolerance was so off my radar that the first time he vomited after eating scrambled egg yolks, I thought it was a stomach bug! Now, when people offer him super eggy things like quiche or custards, my husband and I quietly decline without making a big production about his intolerance. We want food to be something our son savors, not a source of paranoia. Food does have to be managed more closely with allergies/intolerance, but there are ways to handle it without stoking a general apprehension about food the way many restrictive diets do.

Also, I’m with Amy, above. I don’t read everything that’s published about child nutrition, but I feel like I’m well enough informed–and fortunate enough to have thorough medical care–that if something’s really harmful, I’ll hear about it from a source more reliable than Dr. Google.

I think that having a good medical provider – one that you feel you can really trust, who will talk through concerns with you – is so important. I can’t imagine what it must be like to feel that you don’t have that as a resource. I’m thinking of parents who are anti-vax, for example, because this amylase myth is relatively minor compared to vaccine concerns. If you go into the relationship thinking that your pediatrician doesn’t have your child’s best interest at heart or doesn’t know as much as you do (or your online sources) about a health issue, then where do you go from there? This is just to say that I appreciate your last point. I feel the same way. I’ve definitely run into situations where I wished my pediatrician had a more detailed or convincing answer, but I consider her a very good starting point for my questions.

I can’t imagine not having that resource, either. In the US, I think the tendency is to see doctors only when there’s problem–and then, folks see a host of specialists/ER doctors, so there’s little continuity of care and few long-term relationships. Compare that to some countries, where people check in with their *primary care* doc 5+ times/year (these tend to be places with single-payer insurance)–they’re able to build up that trust. And also–all it takes is one negative experience to turn people off to “modern medicine.” My dad once had a doctor prescribe cholesterol medication but then curtly brush off his questions. And THAT’s when my dad started Googling stuff…

This is very timely for me, thank you!
Did you encounter any evidence in your reading that the site of starch digestion changes in infants based on feeding, or just as part of normal growth (I.e. do babies fed more starches develop pancreatic amylase similar to adults faster)?
I ask because my son is about to start solid with the go-ahead of or medical team (pediatrician, dietician, two surgeons and two nurse practitioners- we’re well taken care of!) and he has total colonic aganglionosis Hirshsprung’s disease. No one mentioned needing the colon to digest starch, it’s all been the about electrolytes and water reclamation. I wonder if they’ve not had problems with TCA kids digesting starches due to the small intestine adapting rapidly (for the water, it supposedly can take up to 18 months, and never very well), or whether they just eat more to make up for the loss.

This is a great question. Many enzymes work that way; you give them more substrate, or source material, and they increase activity. Amylase in babies does NOT appear to do this. I’m on my phone and don’t have the sources with me, but several studies found no relationship between amount of starch fed and amylase activity. The increase in amylase appears to be developmental, and it is also quite variable from child to child. Hope this helps, and good luck with your solid foods adventure! Out of curiosity, what foods do your medical team recommend starting with?

Thanks for the info!
We’re to start normally enough, rice and other grain cereals are fine. The only difference for diet at all really is strict on limiting sugar to prevent diarrhoea. We also have to pay more attention to getting constipating foods in the mix early to help firm things up. Possibly adding salt if he starts to go low, but he hasn’t on breast milk, so probably not.
Community-specific baby food lore for you: some Hirshsprung’s parents swear by continuous massive doses of probiotics to get normal stools, but I’m sceptical; seems like the multivitamin issue to me. Okay idea if your diet sucks, but it would be better if your diet didn’t suck. Also, only so much gut critters can do if they aren’t getting the nutrients they need, they either grow in you or they don’t. There’s also the modern obsession with gluten and dairy as no good for the semi-intestinally impaired, which my doctors say is bunk, there is intolerance at the usual rate, but it is much lower than parents perceived rate.

Another fabulous post- I am a pediatrician, and forward your articles regularly to our patients through our facebook page. This is a timely, well-researched and comprehensible article. Keep them coming!

I had a terrible time with baby rice cereal for DD – it reminded me of dishwasher powder soap, and I wasn’t expressing or pumping breastmilk for anything else so didn’t have any ready to mix and it seemed silly (and complicated) to do so for tiny servings of cereal. We skipped over it and did actual grains of cooked rice. Except for the added iron, would there be a difference between the two options (baby rice cereal vs grains of rice)?

And it’s interesting to read that the research shows that delaying solids like I heard about with baby-led weaning/feeding approaches results in an increase in food issues later on. However, it tends to seem like the families that wait the longest are also the ones who are the most restrictive with the family diet – was there any research that showed a relationship between the two traits?

I haven’t seen this type of research, but it’s a really interesting question! Many of the studies on this question are old enough that they would predate Gill Rapley and interest in BLW, though I know some parents have probably been taking a similar approach to solids for as long as there have been babies. (We did just because Cee wasn’t interested in spoon-feeding, but I had no idea that it was a “method” or a book at that point.) One common trend is for moms who start solids later (>6 months in most studies) tend to have higher levels of education, sometimes income, and I would imagine that restrictive family diets are also more common in high income brackets.

Cee also hated rice cereal. For your daughter, was it about the texture or the taste? Or both? Cee basically wouldn’t eat anything off of a spoon. In hindsight, I think I might have gotten anxious and pushy with her. I figured if I kept giving her tastes, she would eventually like it, but I think that may have turned her off from spoon-feeding altogether. Rebooting with finger foods worked great for us but did leave me concerned about iron. Iron is really the nutritional bottleneck for babies, starting around 6 months. Unfortified rice won’t help much with iron, unless you use enriched white rice, which has a bit of iron (still much less than the baby versions). If your baby will eat meat – either pureed or in the form of tender pieces for older babies, that’s really your best bet for iron. I definitely think meats should be emphasized more as first foods.

I’m not recalling now whether the rice cereal was the texture or the taste. We had the same general problems with other baby purees (especially the vegetables and avocado), and given how DH and I react to things, it’s more likely it was the texture. We really switched over to BLW-style table food when we got to ready-made puree green beans, which DH and I both reacted to as just wrong, even though they were only supposed to be beans and water.

I was almost scared to read this post.. in fear that it was going to tell me what so many people around me are constantly saying in.. “dont feed your baby cereal” well news flash.. my child already is allergic to a lot of types of foods.. and oatmeal is surprisingly one of the only things hes not allergic to.. so I am going to feed him it! haha. regardless, thank you for your post. your scientific research, and your reasoning! Would it be okay with you if I shared this on my website as well? please check me out at http://www.iammom.me. Thank you so much! 🙂

Thank you for posting this! I work at a restaurant, and all infant talk aside, there are so many instances of gluten free items. I understand some people have an intolerance (my grandma did before it became such a’popular’ concern), but other than that, I don’t understand why some people say gluten is bad for EVERYONE. I’ve tried to do research on it but it is the same as here- mostly there are people believing strongly one way or another. Gluten is natural right (as in, it isn’t added superficially by processing)? How can it be bad for EVERYONE? I wonder if you have time to explore this fuRther? 😉
Anyway, I did wheat and rice cereal with my two youngest and they’re both well adjusted eaters 🙂 I find it so interesting (just as you had said in another post) that there’s kind of a sweet spot for introducing starch, otherwise we actually increase the chance our kids could have intolerance or allergies.
I get so tired of all the people grand-standing for all natural, organic ingredients. I know they’re better, but if I occasionally feed my kids a fruit snack does that make me a bad mom? I just don’t think so 😉 As you said, and as my mom taught us, everything in moderation.

I know what you mean Cassie H! People think natural & organic = healthy. Arsenic and lead are both “natural” but too much is still not healthy! 😉 I don’t see the difference between a company grinding up the rice for me and adding some iron, or me doing it at home and giving my son an iron supplement, except that the company probably has more rigorous hygiene standards than me.

An interesting group to study gluten sensitivity in would be seventh day adventists, since they are vegetarian, and often eat gluten products to replace meat in their diets. The research on them so far has shown that they have longer life expectancies even when lifestyle factors like smoking and drinking are controlled for, which says to me that gluten is not bad for you if you are not sensitive to it.

This post is fantastic. Whilst my boy is now nearly 4 I started him on ‘solids’ like baby rice and banana when he was 3 months old. In New Zealand during pregnancy we are cared for by a midwife until baby is around 6 weeks old and then transferred over to Plunket. They are a national body who are Registered Nurses and they look after mother and baby, do regular health checks, give ‘advise’ and assist us with our babies until they are around 5yrs old. I remember a Check up we had from the Plunket Nurse when my son was 3 months. I said to her I had given him baby rice because he just didn’t seem ‘satisfied’ with the milk (he was formula feed for medical reasons of mine). Anyway, I got a scalding and told that I shouldn’t be giving him any kind of food, that he shouldn’t have any solids until 9-12 months at the earliest and I should only ever give him formula even if he wanted feeding every 4 hrs. I was told I was silly and just reading things that weren’t possible from a baby.
As a new mum I thought about her comments and being very stong willed I thought to myself ‘what the hell would you know?’ I knew what my baby wanted and milk wasn’t cutting it! To have given him solids and have him sleep for 8hrs was a miracle. To keep it going and introduce new foods each week and he grew and developed faster than the ‘normal average’ baby did. I thought there was something in it.
Sadly to many new mothers read to many things and jump on to many bandwagons. As a parent we need to do what is right for our babies and not what everyone else thinks is right for them.
Reading your article just made me think and feel pleased in my decision to feed solids. My parents did it, their parents did it and I am sure even theirs did it early too!
Thank you for such a great post, it was a great read!
A new fan of scienceofmom 🙂
Asha in Auckland, New Zealand

Hi Liz – Gluten digestion is different, and it’s not the same enzyme (gluten is a protein, not a carbohydrate like starch). I actually haven’t seen any research on gluten digestion specifically in babies (that doesn’t mean it isn’t out there, but I haven’t run across it in all my reading of the research on introducing solids). However, studies do seem to show that it is best to introduce gluten right around 6 months. Introducing it earlier than 4 months or much later than 6 months seems to increase risk of celiac. I just wrote a post about this a few weeks ago if you look back… From that, I’d guess that babies can handle gluten in mid-infancy just fine.

We started our daughter on mixed grain infant cereal at 5 weeks, mixed with her vitamen drops. She was starving, and the stories I heard about rice cereal equalling baby-gut-glue lead me to the mixed grain. We have no family history of food allergies, so I wasn’t worried. I kept nursing until about 9 months. By 5 months she was grabbing peanut butter cookies off a plate and eating them. She has no food issues, eats very well, and is slightly less than average weight for her height at 4 years old.
What leasd me to that was all thestudies about how food allergies could be cured by small exposure to the allergan, including the entire science of allergy shots. Also, my family experience was similar to several here; every infant was started on Cream of Wheat or oatmeal or corn meal mush at about a month. I know this is not scientific, but hanging on my wall in my office is a picture from the 1890s of a mother spoon feeding her about 3 month old infant from a spoon and a bowl of mush…

I love, love, LOVE this blog!! It seems like the complicated world of pregnancy/parenting propagates so much misinformation, old wives tales, etc. Which catches us often in a very vulnerable state, when we want to do the best thing for our children, but don’t know who to believe.

Recently, I’ve heard people warn about the dangers of shaking breastmilk (which compromise the ‘protective proteins’). Have you come across any science that backs this notion up? It seems very counterintuitive to me- given the strong enzymes/acids that breakdown breastmilk anyway. But there seems to be a mention of this on Kellymom and the Mayo Clinic, the latter of which should be a particularly reputable site. Just curious!

Thanks again for sharing your knowledge on the site! I know your readers are eternally grateful!!

With all the “Paleo” dieting going on, and the references to the Weston A. Price foundation I see in online parenting groups, I think this is a VERY relevant post. It’s also a wonderful example of writing about a sticky subject in a way that doesn’t alienate people and walks people through the science in a respectful, accessible, fun, and personable way. Thank you.

“After four to six months, single-ingredient infant foods including fruits, vegetables and cereal grains can be introduced one at a time. This slow process gives parents or caregivers a chance to identify and eliminate any food that causes an allergic reaction.
The introduction of solid foods should not be delayed beyond 4 to 6 months of age. Delaying the introduction of potentially allergenic foods, even in infants at risk for food allergy, has not been clearly shown to be beneficial.”

Reblogged this on Children Are Our Future Now! and commented:
A fantastic and informative article from The Heart and Science of Parenting about the way infants digest amylase and the pros and cons of having it in their diets.

I have been so confused about when to introduce grains. My DS is 11 months and I have not given them yet, but after reading this I am planning to start. I’m hoping I haven’t done any harm by waiting too long. Sometimes it’s so hard to know what to do.

So glad you found this helpful. And I hear you – it is really hard to sort through so much conflicting information. You’re doing the right thing by remaining open-minded enough to change course as needed. That’s such an asset in parenting! Good luck, and I hope your baby enjoys the grains!

it would be great when people write blogs with controversial matters that they would include links and studies to back up their claims. otherwise it just becomes a paper with opinions and I could write a paper with my opinion stating why you are wrong.
do you have studies to back up your claims? id be interested in reading them as well as many others!

Crystal, I completely agree! There are links to about 30 peer-reviewed articles throughout this piece. They are in blue print and become underlined when you hover over them. I used to include citations at the bottom of blog posts but they take up half the page! Hope this helps. Happy reading!

Wow, what an interesting blog post! I am truely astonished that something so science-dense is so popular! I think this is a great sign, in a world where people keep saying how illiterate we are in science. Thanks! I will be following!

Thank you for this post and the research. I will pass this along to our daughter for her consideration. She and her husband now have a 2 month old son. They are very health conscience and I know she will appreciate this information. I breast fed all 4 of my children and started giving them cereal between 3 and 5 months of age because they seemed to need more to satisfy their appetites. I started giving them baby food (fruit first) at about 8 to 10 months. None of them have food allergies thankfully.

Hi, I just discovered your blog, it is wonderful! I did my undergraduate degree at UC Davis, in Nutrition Science. It is so enjoyable to read your blog!!!!! Can’t say enough..will send people to it! take care, Leslie Funk

Thank you so very much for this informative article! I have been debating with myself for a while about whether I did the right thing to introduce the baby to small amounts of rice porridge (among other foods) in the 4th month. Glad to find out it was, after all, the right thing to do, as well as the science behind it! 🙂
Once again, thank you very much for your work!
Elise Carroll

The issue to me, regarding starches, is the apparent randomness in the mainstream recommendations. The science seems clear that babies’ bodies are prepared to digest foods in almost exactly the reverse order from what is currently recommended. So should we panic over EVER feeding our babies grains? No. But it seems pretty foolish to start them with grains as their earliest foods, which they’re getting the most of for the longest time, and hold off on the things (fats, proteins) they’re obviously prepared to digest, as evidenced by the fact that they’re the primary components of breastmilk.

I think that’s a fair critique. Recommendations on solids have, for a long time, been based more on tradition and opinion than on science. Grains are just such a major source of calories in cultures around the world, and they’re easy to prepare and well-liked by babies, but I agree that they aren’t ideal first foods. I think the best first foods for babies are meats and egg yolk, not so much because of digestion efficiency but because of the nutrients that they provide (iron, zinc, and fats especially). Still, there’s no evidence that it’s harmful to start with a cereal, and there’s some evidence that feeding cereals in infancy helps to prevent allergies, so I think variety is key.

I wish I hadn’t had to read thru almost a year’s worth of comments to read that you believe that grains “aren’t ideal first foods.” From your article, I thought you thought they were nearly the perfect first food. As moms search for information on this topic, they will undoubtedly land on your page. Even if they have read 20 other articles in favor of choosing different foods for the first food (with plenty of scientific research to back it up), if they are looking for someone to tell them that they are right, they will read yours and say what many of the women here said…”See? I know all those people were wrong!” But that’s not actually what you are saying, is it? So is that really what you want women to take away? If helping moms make the best choices for their babies is a goal of yours, perhaps you could update your article and give a little bit of info on the science of why, despite your research on grains, you actually think there are better options for a babies first foods.

There’s a couple of things I feel like you didn’t delve into that are important. You talk about undigestible starches and feeding the bacteria…but are you making an assumption that each baby has good gut flora to start? In our society, I think that is a bad assumption. If babies are being born with imbalanced gut flora (because of a c-section, antibiotics during pregnancy or birth, moms imbalanced flora to pass on, mom’s diet, medications from mom or baby, etc), then feeding the bacteria isn’t actually a good thing. You also mention fussiness and gassiness in babies as THE symptom of a negative reaction. First that assumes that a new mom even realizes the signs of a fussy or gassy baby, or realizes that fussiness or gassiness is not “normal”. I know moms who just gave gas drops with every meal…because the doc told them to. And I can’t tell you how many times a well meaning matriarch has said “babies cry!” when one of my kids was screaming (in gut pain…aka colic.) Clearly there was intestinal issues in both that just got masked by meds or by wrong information! And unfortunately, that constant unresolved GI upset leads to more problems later on…something that I could have likely been avoided had I recognized the problem and known what to do about it then. Pinpointing things like that in babies who can’t talk is SO hard. Second, that assumes that GI distress will only manifest itself in pain or gas. However, research is also showing there is so much more to our gut issues then just tummy upsets…ezcema, non-normal pooping (and most of us don’t even know what “normal” is), auto-immune diseases, behavior, even recurrent illnesses, etc. So if moms are only looking for tummy trouble as a sign that a food isn’t well tolerated, they are setting their kids up for bigger problems.

I suspect you wrote this to unpack the issue and help other moms do so as well so I only took the time to reply to this because I want the same for moms. And the information, when you are looking into things that go against our current norms, is overwhelming. I personally always try to ask myself…how did our ancestors do it (like more than 100 years ago…and before)? There was a time, several generations ago, when chronic disease was not the norm. If that was the case…what did THEY eat? To me, those thousands of years of empirical evidence is as relevant (or more!) as the last 100-150 years of research, when our world is just so sick (healthwise) right now. Thanks for taking the time to read this!! Be well!

Very informative. Many people consider themselves experts just because they heard “something” out there. I love to have information with science to back it up to make up my mind on dietary recommendation. Thanks for the post.

The references are all embedded as links in the post, but I’ve gotten this comment a lot. Either it is hard to see the hyperlinks, or people really prefer a references list, or both? Any input? My fear with the reference list is that it just takes up SO much of the page that readers end up missing the comments and the often valuable discussion that happens there. But I will add references to this post when I get a chance – there are more than 30 in this post!

I can see what you mean – adding 30 references at the end of a blog post might be cumbersome. I did notice your embedded links and was able to access the articles I was interested in. Thanks for doing this by the way. I also appreciate seeing science that backs up what you are writing. It really makes a difference.

I just thought of a possible solution to your references issue. Perhaps make a comment at the end of each article that all the references are linked within the text of the post – or something like that. The wording may have to be improved.

The only other suggestion I have is to bold the links or bold one word of the link – if this seems to be an important enough concern.

I’ve read so much conflicting information on this topic and there seems to be science backing up both sides. It’s hard to decide what to do! What I’d like to hear is some evidence backing up the claims that delaying introduction to certain foods can CAUSE allergies because there is certainly the opposite claim that introducing these foods too early can lead to them. Can you provide some evidence or scientific explanation?

Thanks for the unbiased article! I have a 7th month old who is very interested in food and loves to eat the pears and bananas that we are giving him now. However, he has a history of throwing up when we give him grains. We started giving him homemade brown rice pureed with breast milk at 2 months old. He loved it, but my husband noticed that Baby was getting fussier, so we stopped. When we tried it again at 5 months, he still liked it, but after 2 hours he started vomiting violently–like every 15 minutes for an hour till it was just green bile. We waited another month, tried oatmeal, which he hated and only ate maybe 1/2 teaspoon of, and again with the vomiting. He’s 7 months old now, and I just gave him sweet potato puffs (wheat, oat, sweet potato, etc). More vomiting. Have you heard of this? Does it sound starch related? I’m confused that the vomiting didn’t start at 2 months, and wondering what to do next?

I don’t know what to tell you! Have you consulted with your pediatrician? It seems strange to have that reaction across several types of grains. If you find out, I hope you’ll leave a follow-up comment. Good luck!

I have to be honest I’ve never subscribed to a blog before but after hours of personal research, and several mom friend misinforming me on this subject I was so uttterly thrilled to read this article. It was so helpful how could I not subscribe can’t wait to read more from your blog!

This is very well written and researched. I found the information herein most useful. Where I live (South Africa), there isn’t any negative talk amount starch other than advice to first intro vegetables, then fruit, then protein, then grains. I feel it necessary to just mention that there are very real (albeit) circumstances where an infant lacks enzymes to break down starches or the existing enzymes may have reduced efficacy in breaking down starch. This results in excessive amounts of undigested starch and disaccharides remaining in the intestine causing horrible bloating, gas, abdominal cramps and osmotic diarrhea. These symptoms are severely distressing to infant and parent alike! I have travelled that journey for 10 months now, my baby having been diagnosed with Cingenital Sucrase Isomaltase Deficiency. I am a supporter of “all things in moderation”, and I find it very trying not being able to offer by little one oats or wheat or maize porridge or even a tablespoon of mashed potato or sweetpotato! 😦 I am constantly trying to challenge her upper tolerability of non-grain starch and would do anything to be able to feed her a bowl of grain-based starch!!!! I am grateful she can manage bananas and legumes! I’m remaining hopeful, that in time, she might be able to tolerate more starch!!! Thanks again for sharing your research findings. It has helped me grasp certain things better!

Wow I am so grateful I came across your article as this topic is HOT in my mama groups! I will even admit to being guilty of passing on my obvious misinformation to friends after my googling efforts! I am currently in the process of introducing solids to my son, and was reading the other day that the fear around serving strictly only egg yolks is no longer, and that the recommendation is changing to whole eggs- I would really love to know your thoughts on this as you are obviously well versed in finding the best, most accurate sources!

Hi Kim – Glad you find this useful! It’s amazing how quickly misinformation can spread in parenting circles, and it’s easy to be confused! As far as eggs, I think it makes sense to start with the yolks. Almost all of the iron is in the yolk, and it also has good fats. The white is mostly protein, and babies are still getting plenty of that from breast milk or formula. There’s also some evidence that a protein in egg white might inhibit iron absorption. That said, whole egg is fine. I’ve fed bits of it to my 6-month-old when we have scrambled eggs. Just know that the most useful stuff for babies is in the yolk. Hope this helps!

Just started introducing rice cereal to my 6 month old. It is clearly giving her terrible gas and discomfort. If this is not because babies can’t digest grains then what is the reason? Should I skip grains for now or is there something I can do to prevent the gas?

Sorry your baby is experiencing this! It’s normal for it to take a couple of days for baby’s GI tract to adapt to different types of foods, especially these first foods. There is a normal shift in gut microbes and expression of digestive enzymes. Gas and discomfort doesn’t mean that your baby can’t digest grains. I would just start slow and give her a little time. You also don’t have to start with rice cereal, and in fact, I don’t recommend it. Infant cereals are fine, but I recommend not making rice cereal a daily food, as I explain in this post. You can also go ahead and try more interesting foods, like fruits and vegetables or meats. I hope this helps! https://scienceofmom.com/2014/10/14/the-whole-truth-about-infant-cereals-7-science-based-tips/

hiiii, just today i stumbled in to this article and find your site a kind of life saver for me. so many questions and restrictive thought related to baby food keeps haunting.. n eureka.. foud ans in your article. thans a tone mam…

Thank you so much for this blog. It’s refreshing to have someone that can say “I don’t know” when they don’t know, who does the research with an intent to follow that rather than “sides”, and who educates very effectively. I’m a pediatric resident and those characteristics I just described are exactly what I hope to be, thank you

This seems way too opinion based than factual. First of all there is a difference between restricting food and just not introducing. There is zero advantage to giving a small child sugary treats and it is ok not to, it’s not going to cause harm not introducing that food until a later time. There is a difference if your child is asking for it and a two year old doesn’t understand moderation. If your child doesn’t show an interest, delay introducing it (or will they develop allergies to junkfood?). Also parents need to take responsibility for modelling proper eating behaviours, this is where healthy eating really begins. In regards to infant cereal, there is lots of evidence that very minimal iron is absorbed since it is synthetic plus parents often add formula or breastmilk (calcium competes with iron absorption). This actually creates the problem of not enough nutrients but filling the belly and taking up the space of nutrients you could be giving to your child. There are many factors in developing allergies to food and it is way more common for kids to be allergic to food in the last 20 years more than ever, I doubt delaying grains is the reason for that and I would be more suspect to box and processed foods and they are not real food.

Welcome!

Welcome! I'm the author of The Science of Mom: A Research-Based Guide to Your Baby's First Year, published by Johns Hopkins University Press in 2015. I write about science, health, parenting, and nutrition here and for other print and online outlets.
Find more about me at my website: https://alicecallahanphd.com/

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